CONIFER PARK, INC. (NPI# 1336339969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336339969 |
Entity Type | Organization |
Organization Name | CONIFER PARK, INC. |
Practice Address |
79 Glenridge Rd Cottage #1 Glenville NY 12302-4523 |
Mailing Address |
Po Box 417153 Boston MA 02241-7153 |
Practice Telephone | 5189528121 |
Practice Fax Number | 5189528287 |
Mailing Telephone | 5189528140 |
Mailing Fax Number | 5189528287 |
Enumeration Date | 2007-07-30 |
Last Update Date | 2013-03-26 |
Authorized Official Name | BARBARA A PETTEYS (DIRECTOR OP BILLING) |
Authorized Official Telephone | 5189528140 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
081110730 | NY | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 01420800 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730379504 | Conifer Park, Inc. | Clinic/Center | 323 Lake Hill Road, Hawley Cottage, 1st Floor, Burnt Hills, NY 12027-9772 | 2007-07-27 |
1346296720 | Conifer Park, Inc. | Clinic/Center | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2006-05-26 |
1235185612 | Conifer Park, Inc. | Clinic/Center | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2006-05-26 |
1366498768 | Conifer Park, Inc. | Clinic/Center | 526 Old Liverpool Rd, Liverpool, NY 13088-6238 | 2006-05-26 |
1972558179 | Conifer Park, Inc. | Clinic/Center | 55 Elm St, Glens Falls, NY 12801-3549 | 2006-05-24 |
1356396543 | Conifer Park, Inc. | Clinic/Center | 2435 6th Ave, Troy, NY 12180-2227 | 2006-05-24 |
1154652709 | Conifer Park, Inc. | Substance Abuse Rehabilitation Facility | 15 Henning Rd, F. Donald Myers Education Center, Saratoga Springs, NY 12866-3749 | 2010-01-21 |
1366632986 | Conifer Park, Inc. | Clinic/Center | 216 Main St, Suite #2, Hudson Falls, NY 12839-1813 | 2007-07-30 |
1023208139 | Conifer Park, Inc. | Clinic/Center | 1051 Dix Ave, Buildings E and G, 1st Floors, Hudson Falls, NY 12839-1053 | 2007-07-26 |
1649225897 | Conifer Park, Inc. | Clinic/Center | 600 Franklin St, Schenectady, NY 12305-2100 | 2006-05-24 |
Entity Type | Entity Name | Entity Address |
---|---|---|
New York State Corporations | CONIFER PARK, INC. | 79 Glenridge Road, Glenridge, Ny 12302 |
Street Address |
79 GLENRIDGE RD COTTAGE #1 |
City | GLENVILLE |
State | NY |
Zip Code | 12302-4523 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083645535 | Christopher J Rizzo | Internal Medicine | 79 Glenridge Rd, Glenville, NY 12302-4523 | 2006-07-05 |
1538726229 | Samuel John Halajian | Physician Assistant | 79 Glenridge Rd, Glenville, NY 12302-4528 | 2019-05-29 |
1801235155 | Elizabeth Magliocca | Registered Nurse | 79 Glenridge Rd, Cottage #1, Glenville, NY 12302-4523 | 2013-06-20 |
1093158453 | Kristen Rizzuto | Counselor | 79 Glenridge Rd, Cottage #1, Glenville, NY 12302-4523 | 2013-04-16 |
1043515380 | Nicole Lifite | Registered Nurse | 79 Glenridge Rd, Glenville, NY 12302-4523 | 2011-01-18 |
1073829578 | Patricia Anne Pulver | Physician Assistant | 79 Glenridge Rd, Glenville, NY 12302-4523 | 2010-08-23 |
1588843569 | Mirabelle Beck | Nurse Practitioner | 79 Glenridge Rd, Glenville, NY 12302-4523 | 2007-10-26 |
1336344258 | Matthew Levine | Physician Assistant | 79 Glenridge Rd, Glenville, NY 12302-4523 | 2007-06-20 |
1740364215 | Timothy Donnelly | Physician Assistant | 79 Glenridge Rd, Glenville, NY 12302-4523 | 2006-10-24 |
1518057272 | Danesh Irani | Physician Assistant | 79 Glenridge Rd, Glenville, NY 12302-4523 | 2006-10-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053921973 | Maria Magnoua Castaneda | Case Manager/Care Coordinator | 701 Carnbridge Manor Dr., Scotia, NY 12302 | 2020-08-05 |
1184050353 | Empire Vision Centers, Inc | Eyewear Supplier (Equipment, not the service) | 10 Glenridge Rd Store#1, Glenville, NY 12302 | 2013-09-19 |
1265773212 | Caroline M Lupi | Licensed Practical Nurse | 19 Glenridge Rd Ste E, Glenville, NY 12302 | 2013-03-14 |
1477805844 | Kinum Chiropractic PC | Chiropractor | 201glen Ave., Scotia, NY 12302 | 2012-10-10 |
1558686444 | Marsha M Tulloch | Licensed Practical Nurse | 125 Mohawk Ave, Gentle Home Health Care, Scotia, NY 12302 | 2010-04-02 |
1841515988 | Maureen K. Hansen | Licensed Practical Nurse | 109 Mohawk Ave., Gentle Home Health Care, Inc., Scotia, NY 12302 | 2010-04-01 |
1275858425 | Flora Lynn Worden | Licensed Practical Nurse | 109 Mohawk Ave, Scotia, NY 12302 | 2010-03-31 |
1255654943 | Kevin Daniel Valade | Pharmacist | 257 Saratoga Rd., Glenville, NY 12302 | 2010-03-09 |
1356574149 | Ann Elizabeth Helbling | Community Health Worker | 419 Weatherwax Road, Glenville, NY 12302 | 2009-08-27 |
1689811317 | Roger Guy Singer | Chiropractor | 353 Saratoga Road, Scotia, NY 12302 | 2009-01-16 |
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Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.